Diet and Inflammatory Bowel Disease

By: Ruth Kander, Dietitian Bsc (Hons) SRD

IBD affects everyone in a different way – there is no one rule for all and everyone will have different dietary requirements. In medicine, and in this case nutrition, we practise evidence based medicine which means that healthcare professionals usually only make recommendations based on the best medical research available at that time. The evidence for nutrition in IBD is variable and there is still much research to be done.

Healthy Eating

Everyone is aware of the importance of a healthy balanced diet for good health, but some people who have IBD may not be able to tolerate a normal diet, especially the 5 a day rule of fruits and vegetables. Often people with IBD are unable to tolerate fruits and vegetables for a variety of medical reasons such as strictures/narrowings, fear of blockages, surgical intervention or simply intolerance. I always suggest to people to be rational about this and think about which fruits and vegetables agree with them. People often find that the lower fibre varieties of cereals, fruits and vegetables suit them best.

Tips for having fruits and vegetables:

Always peel fruits and avoid those with pith

Eat boiled/cooked vegetables and make sure they are peeled

Avoid small vegetables like peas, beans and corn which can get caught in the bowel

Everyone will have different views on whether it is beneficial to go gluten/wheat free. There is no research to suggest it is. Some avoid brown/wholegrain varieties or fear of seeds getting stuck or causing a blockage, which is reasonable.

If you are trying to gain weight, then have a larger portion at meals and have some high carb snacks.

If you are trying to lose weight, then control your portion sizes.

Proteins

Usually people who are in remission and are well tolerate protein foods without a problem. It is recommended to have two portions daily. This means:

Meat/chicken the size of palm of your hand

Eggs 1-2

Beans/lentils 4 tablespoons

If you are vegetarian or vegan you may consider having more soya/tofu/quorn products rather than beans and lentils which the body can find harder to digest, and which may cause a blockage.

Dairy foods

Some people find they are intolerant to dairy foods which could be due to either lactose or milk protein. If you exclude dairy foods, discuss this with your doctor as you will be missing out on calcium in your diet.

It is recommended to have 3-4 portions of dairy foods daily to ensure adequate calcium intake.

In summary

Try to have a healthy balanced diet each day

If you have multiple food intolerances, ask to be referred to a specialist gastroenterology dietitian

If you feel more comfortable with low fibre fruits, vegetables and carbohydrates, then have those

Eat 2 portions of protein daily

Ensure you have an adequate fluid intake each day

Be as active as possible each day

About the author

Ruth Kander Bsc (Hons) SRDDietitian

Ruth has 18 years experience as a dietitian in the NHS and 10 years in the freelance sector. She has covered many clinical areas but her specialist area in nephrology.

Ruth currently works as a dietitian at Imperial College Healthcare NHS Trust and also has a freelance practice. She has won a number of awards; Development of a training pack for nurses in nutrition, The British Dietetic Association Elizabeth Washington award for online doctors nutrition education, an award for dedicated patient care at Imperial College Healthcare NHS trust, the Star awards and the Full Monty award at Cambian Healthcare for dietetic service.

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The information on this site is for guidance only. It is not a substitute for professional medical care by a qualified doctor or other health care professional. Always check with your doctor if you have any concerns about your condition or treatment.